The Journal of Contemporary Dental Practice

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Volume 23, Number 1, January 2022


Sujatha Govindarajan, Vishnu P Veeraraghavan, Theerthika Dillibabu, Shankargouda Patil

Oral Cavity–A Resilient Source for DNA Sampling

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-10024-3269  |  Open Access |  How to cite  | 


Gino Silvestre, Soohan Chung, Elvin Tolentino, Vincent Chee, Udochukwu Oyoyo, John Won, So Ran Kwon

Impact of COVID-19 on Teaching the Tooth Morphology Course to the New Generation of Learners: A Cross-sectional Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:3 - 7]

Keywords: COVID-19 pandemic, Dental education, Generation Z, Learning style, Tooth morphology

   DOI: 10.5005/jp-journals-10024-3279  |  Open Access |  How to cite  | 


Aim: The purpose of the study was two-fold. First, to evaluate students’ learning style and relate it to their academic performance. Second, to highlight changes implemented in the tooth morphology (TOMO) course as a response to the coronavirus disease-2019 (COVID-19) pandemic. Materials and methods: The study was performed during 2021–2022 with 101 dental students. Didactic lectures were delivered online and students challenged with nine quizzes and one final examination. Didactic score was calculated by averaging the scores of quizzes and the final exam. Lab score was a combination of five lab projects and the final competency. At course completion, students received a survey on their learning style and how they would like to receive feedback. Kruskal-Wallis test was used to assess differences in didactic and lab scores among groups. Results: Many students perceived themselves as visual learners (39%) followed by kinesthetic (24%), aural (19%), and reader (18%). There was no difference among learning style groups in performance of didactic (p = 0.340) and lab scores (p = 0.845). Students preferred that the instructor talks them through the questions for feedback on quizzes (41%) while they preferred demonstrations when receiving feedback on their wax-ups (51%). Most students (75%) preferred a TOMO teacher that uses demonstrations. 2020–2021 marked the year of the pandemic where all lectures were delivered online and waxing projects were performed at-home. A postpandemic transformation occurred during 2021–2022, reverting to conventional in-person lab sessions while keeping online didactic lectures. Conclusion: We conclude that TOMO should be delivered by using various teaching styles rather than focusing on a single method while providing more demonstrations. Clinical significance: Teaching tooth morphology to the new generation type of learners efficiently will affect the clinical work of dental graduates.


Waseem S Al-Gumaei, Reem Al-Attab, Maged S Alhammadi, Remsh K Al-Rokhami, Abeer A Almashraqi, Ge Zhenlin, Ehab A Abdulghani, Yan Zheng

Evaluation of Spheno-occipital Synchondrosis Fusion in Chinese Population Using CBCT: A Cross-sectional Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:8 - 13]

Keywords: Chinese population, Cone-beam computed tomography, Skeletal growth, Spheno-occipital synchondrosis, Stages of fusion

   DOI: 10.5005/jp-journals-10024-3257  |  Open Access |  How to cite  | 


Aim: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese population using cone-beam computed tomography (CBCT). Materials and methods: This is a cross-sectional study in which data were randomly collected based on the pre-existing institutional records. Following selection criteria, the CBCT images of 500 patients aged 6–25 years (226 males and 274 females) were analyzed. Three-dimensional virtual models were oriented at a standardized position, then adjusted to the median sagittal plane (MSP) view. A four-stage scoring system was used; completely open, partially fused, semi-fused, or completely fused. The student\'s t-test, one-way ANOVA, Pearson correlation, and linear regression analysis were used and the significant level was set at ≤0.05. Results: The mean age of closure of stages 1, 2, 3, and 4 were 7.44, 9.62, 12.94, and 19.03 years in females, and 8.79, 11.13, 14.82, and 20.18 years in males, respectively. There was significantly strong positive correlation between spheno-occipital fusion and age (female: r = 0.853, male: r = 0.879; p <0.001), with 1.47 ± 0.33 years earlier fusion in females. All inter- and intra-stages mean ages were statistically significant in both genders. The transition age model demonstrated a mean age (in years) between stages 1–2 (10.1), stages 2–3 (12.79), and stage 3–4 (17.93) for males, and stages 1–2 (8.96), stages 2–3 (11.45), and stage 3–4 (16.69) for females. Conclusions: The present findings of SOS stages of fusion in both genders could guide age estimation and assessment of normal skeletal growth patterns and active skeletal growth period in the Chinese population. Clinical significance: There is still controversy about the time to closure of the SOS because of population and assessment technique variations. This study could be used as a reference for the specific examined population during planning for dentofacial orthopedic and/or orthognathic surgery and dental implant prosthesis for both genders. Moreover, these finding may be useful for medical purposes.


Mohammad Yaman Seirawan, Mohammad Kinan Seirawan, Mazen Doumani

Comparative Evaluation of Potential Dentinal Microcracks Related to Instrumentation alongside Bypassed Broken Instruments: An In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:8] [Pages No:14 - 21]

Keywords: Bypassed broken instruments, Dentinal microcracks, Microscopic magnification

   DOI: 10.5005/jp-journals-10024-3282  |  Open Access |  How to cite  | 


Aim and objective: To investigate the occurrence of microcracks in the canals containing broken instruments in the middle and apical thirds after instrumentation with various systems. Materials and methods: One-hundred and fifty mature mandibular premolars with single straight canal were collected and stored in distilled water. Samples were checked out from any preexisting deformation or cracks, and then standardized in length. Thirty teeth were never instrumented (NI) as a control group, 60 teeth have received a broken instrument in the middle third, and 60 ones at the apical third. Teeth were placed in resin blocks with simulation of periodontal ligaments. After bypassing the instruments, samples were divided into four groups n = 30; first group was prepared manually MN until 25/0.02, while the other three groups were prepared until 25/0.04 using three different rotary systems; Race RC—2Shape TS—Hyflex CM HCM. Roots were cut transversely at levels of broken instruments and examined under 40× microscopic magnification. Results: All the rotary groups produced microcracks. No significant difference of the partial cracks was observed among all groups at the middle and apical levels p >0.05. TS produced more complete cracks compared to each of NI, MN, RC at middle level and NI, MN at apical level; p <0.05. No significant differences of microcracks incidence were observed between two middle and apical levels among the five groups. Conclusion: Dentinal microcracks could be obviously resulted after rotary instrumentation alongside broken instruments, while manual shaping was less likely to cause microcracks. Clinical significance: Manual files were less likely to induce microcracks alongside broken instruments in comparison with rotary files which could be considered much safer.


Rafael Cury Cecato, Elizabeth Ferreira Martinez, Cesar Augusto Magalhães Benfatti

Analysis of the Viability and Morphology of Gingival Cells on Materials Used in Novel Prosthetic Components: In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:9] [Pages No:22 - 30]

Keywords: Biocompatible materials, Cytotoxicity, Dental implant abutment, Dental materials, Oral mucosa

   DOI: 10.5005/jp-journals-10024-3271  |  Open Access |  How to cite  | 


Aim: The objective of this in vitro study was to evaluate the viability and morphology of human fibroblasts and keratinocytes cells, both grown on stainless steel (steel) (18Cr14Ni2.5Mo), and polyether-ether-ketone (PEEK) surfaces, hypothesizing the use of these surfaces as novel materials for prosthetic components. Materials and methods: Gingival human keratinocytes and gingival human fibroblasts lines were grown on discs made by steel (n = 36), PEEK (n = 36), and titanium (Ti) (Ti6A14V) (n = 36)—control. For viability assay, cultures were grown at 24 hours (TV1), 48 hours (TV2), and 72 hours (TV3) times and evaluated by the colorimetric tetrazolium assay (MTT). For morphology and cell adhesion assays, after 24 hours (TM1), 48 hours (TM2), and 96 hours (TM3) of cell culture, cells were examined by scanning electron microscopy (SEM) and analyzed at magnifications with 500×, 1,000×, and 2,500×. Results: Regarding the viability, the keratinocytes did not present statistical difference on the different materials, in TV1 and TV3 times of culture. Their growth rate increased on all materials, being more expressive in steel; the fibroblasts did not present statistical difference on the different materials, in TV2 and TV3 times of culture. The growth rate of these decreased on all materials, being more expressive in PEEK. The morphology analyses show increase in cell numbers, adequate spreading, and adhesion at all cultivation times (TM1, TM2, and TM3) in both cell lines, on all materials. Conclusion: All materials tested are suitable for use in the manufacture of prosthetic components for implant-supported rehabilitations, considering the limitations of this study. Clinical significance: This work analyzes the cellular response of cells present in the human gingiva, as a way to simulate the peri-implant tissue response around novel angular prosthetic components made of stainless steel and PEEK.


Alessandra Kuhn-Dall'Magro, Eduardo Zamboni, Tobias Fontana, Letícia C Dogenski, João P de Carli, Eduardo Dall'Magro, Fernado Fornari

Low-level Laser Therapy in the Management of Oral Mucositis Induced by Radiotherapy: A Randomized Double-blind Clinical Trial

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:31 - 36]

Keywords: Laser therapy, Oral mucositis, Radiotherapy

   DOI: 10.5005/jp-journals-10024-3277  |  Open Access |  How to cite  | 


Aim: The present study evaluated the effect of LLLT at red and infrared wavelengths associated with therapeutic measures from the Mucositis Study Group of the Multinational Association of Supportive Care of Cancer and International Society of Oral Oncology (MASCC/ISOO) for preventing and treating RT-induced oral mucositis (OM). Materials and methods: For the study, 80 subjects diagnosed with head and neck cancer (HNC) undergoing treatment were randomized into three groups to apply different photobiomodulation protocols for 42 days, as follows: Group I—LLLT of 660 nm; Group II—LLLT of 810 nm; and Group III—association of wavelengths of 660 and 810 nm. The treatments were performed by properly trained professionals and with equipment calibrated for the intervention. Results: Different OM scores were noted for the groups studied, and the third group had lower scores than Groups I and II (p = 0.012). No difference was noted in the pain score analyzing the groups (p = 0.49). Conclusion: The LLLT was effective for OM lesions in individuals treated with radiotherapy associated or not with chemotherapy. When combined, the red and infrared lasers reduce OM scores. Clinical significance: OM is one of the main adverse effects of antineoplastic therapy in head and neck cancer patients. The evidence supporting the validity of LLLT for OM can improve patients’ quality of life.


N Kiran Kumar, Anoop Nair, Savitha B Naik, Annie Swathisha, CH Laxmi Priya, HS Preetham, V Shylaja

A Shift to Synergistic Surface Treatment Using Laser to Enhance the Bonding of Zirconia to Veneering Ceramic: An In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:37 - 42]

Keywords: Air abrasion, Bond strength, Er YAG laser, Yttria-stabilized tetragonal zirconia polycrystal

   DOI: 10.5005/jp-journals-10024-3275  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the effect of combination of surface treatment using laser along with other modalities of surface treatment on shear bond strength of zirconia to veneering ceramic. Materials and methods: Milled and sintered zirconia cylinders (n = 150) were used in the study which were divided into six groups that were subjected to various surface treatments. Samples in group I were subjected to sandblasting. In group II Laser (Er: YAG) surface treatment was performed. Samples in group III were subjected to sandblasting followed by laser ablation. In group IV laser ablation was carried out followed by liner application, and samples in group V were subjected to laser ablation followed by argon plasma treatment. Instron machine was used to test the shear bond strength (SBS). One-way ANOVA and Bonferroni test were used for statistical analysis. Result: Samples in group III showed highest values for SBS followed by groups I, IV, and V with less SBS value for group II. Conclusion: Thus, the results conclude the use of combination of surface treatment using laser to be an effective modality to enhance the shear bond strength of zirconia. Clinical significance: Synergistic surface treatment using laser increases the bond strength of zirconia prosthesis to veneering ceramic improving its clinical longevity.


Wasiur Rahman Choudhury, Sridhar Nekkanti

Mechanical Properties of SDR™ and Biodentine™ as Dentin Replacement Materials: An In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:43 - 48]

Keywords: Dentin replacement materials, Glass ionomer cement, Microhybrid and nanohybrid composite resins, Shear bond strength

   DOI: 10.5005/jp-journals-10024-3281  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the shear bond strength of nanohybrid composite resins (NCR) and microhybrid composite resins (MCR) placed over three different dentin replacement materials: SDR—Smart Dentin Replacement™, Biodentine™, and resin-modified glass ionomer cement (RMGIC). Methods and materials: Thirty acrylic blocks (50 mm × 20 mm × 15 mm), each with a central hole, were prepared, which were randomly distributed into three equal groups, each corresponding to one of the three dentin replacement materials—SDR, Biodentine, and RMGIC. The central holes were then filled with these materials. After setting and application of the respective adhesive system, the specimens were further divided into two subgroups each of NCR or MCR. The respective composite material was then applied to the dentin replacement materials using a cylindrical plastic matrix. Shear bond strength was tested on a universal testing machine (Instron 3366), at a crosshead speed of 1.0 mm/minute. Results: SDR attained consistently higher shear bond strength (means: 21.18, 22.19 Mpa) values than RMGIC and Biodentine, with both types of composite resins (MCR and NCR), which were statistically significant (p <0.001). When considering the means of the shear bond strength measurements obtained by the two types of the composite resin, no significant difference (p <0.05) was found between them with all three types of dentin replacement materials. Conclusion: There is no significant difference in the bond strengths achieved between MCR and NCR to the different dentine replacement materials. Hence, either type of composite resin may be expected to achieve similar bond strengths to the underlying substrate. SDR™ is a suitable dentine replacement material for placing below a composite resin veneer as it can achieve immediate higher bond strengths. Clinical significance: SDR can be used as an effective bulk fill material in deep dentinal caries which can be capped with composite resins.


Poonam Agrawal, Neelima Katti, Devapratim Mohanty, Shib Shankar Pradhan, Subash Chandra Raj, Dharmashree Satyarup, Annuroopa Mahopatra, Peri Srivani

Treatment of Localized Gingival Recession Using Gingival Unit Grafts: An 18-month Follow-up Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:7] [Pages No:49 - 55]

Keywords: Gingival recession, Gingival unit graft, Longitudinal studies

   DOI: 10.5005/jp-journals-10024-3276  |  Open Access |  How to cite  | 


Aim: The study aimed to longitudinally evaluate the efficacy of gingival unit grafts (GUGs), a modification of free gingival grafts, in the management of Miller\'s class I and class II recession defects in mandibular anterior region, over a period of 18 months. Materials and methods: 17 subjects with 21 recession defects in mandibular anterior region were treated using GUG. Clinical parameters of recession depth (RD), clinical attachment levels (CALs), and keratinized tissue width (KTW) were recorded at baseline, 1, 6, and 18 months. Patient-centered outcomes were measured using a visual analog scale (VAS) for pain and discomfort on 14th postoperative day and for treatment satisfaction at the end of 18 months. Results: There was a statistically significant improvement in RD, CAL, and KTW at 18 months when compared to baseline levels. A mean root coverage (MRC) percentage of 84.76 ± 11.79% was achieved at the end of 18 months. Patient-related outcomes for VAS for pain and discomfort as well as treatment satisfaction showed favorable results. Conclusion: GUG can be used as a predictable treatment modality for Miller\'s class I and class II recession defects in mandibular anterior region. The results obtained can be well maintained over 18-month period with optimal maintenance care. Clinical significance: The advantage of involving marginal gingiva in GUG results in a well-contoured graft, which increases the ease of adaptation and suturing. The biological characteristic of intact marginal vasculature results in early integration of graft into the recipient area and greater success in graft survival over denuded root surface, causing better long-term RC outcomes.


Prashant Mishra, Amrit Tandan, Ganiga C Shivakumar, Kapil Choudhary, Sahana Shivakumar, Navdha Sharma, Anurag Saxena

Evaluation of Crestal Bone Loss in Flap vs Flapless Implant Placement Technique: An In Vivo Comparative Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:56 - 60]

Keywords: Crestal bone loss, Delayed loading, Flapless surgery, Implants

   DOI: 10.5005/jp-journals-10024-3219  |  Open Access |  How to cite  | 


Aims: The aims of the study were to assess the technique with-flap and flapless implant placement and to compare crestal bone heights around the implant in flapless and conventional flap technique using digital radiovisiograph, in 3 and 6 months after the surgery. Materials and methods: A total of 20 implants were placed by flap and flapless implant technique; each patient received two implants, except for two patients who received four implants. A radiovisiograph was taken at implant placement, as well as 3- and 6-month intervals. Crestal bone level was compared between flapless and flap during these intervals and compared between intervals for each group. Results: On evaluating the distribution, it was found to be asymmetric and hence lacked normality (K–S = 0.382; p <0.001). On mesial side, bone loss values in group I ranged from 0.40 to 1.10 units with a mean value of 0.71 and a standard deviation of 0.26 units. The median value was 0.70. On evaluating the data for normality, it was found to be symmetric and normal (K–S = 0.166; p = 0.200). Conclusion: This study concluded that there are not any significant differences in the crestal bone with both flap and flapless techniques. Comparatively, the flapless approach showed a lesser crestal bone height reduction, which was statistically significant. Clinical significance: Implant dentistry is nonetheless behind when advances are concerned, we have seen the inclination toward minimal invasive implant techniques to yield better esthetic as well as improved results, thus taking care of patients’ discomfort.


Mrinmoy Chakraborty, Amitu Singh, Suneel V Vadavadagi, Amrita Kumari, Ravi S Prasad, Abhishek Anand

Evaluation of Microleakage Using Dye-penetration Method in Three Different Composite Resin Core Build-up Materials: An In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:61 - 65]

Keywords: Composite resin, Core build-up materials, Dye-penetration, Microleakage

   DOI: 10.5005/jp-journals-10024-3220  |  Open Access |  How to cite  | 


Aim: Aim of the current research is to establish and assess the microleakage in bulk-fill composite, nanohybrid ormocer-based resins, and nanofilled composite resin core build-up materials employing the dye-penetration technique. Materials and methods: Sixty human mandibular first premolar teeth with a solitary root canal without dental caries were chosen for this research. Each specimen was subjected to decoronation of 2 mm from the cementoenamel junction (CEJ), following which the root canal treatment procedure was rendered complete. A space for the post was made for all the 60 samples. Following positioning of the post, specimens were allocated into one of the following three investigational groups (20 specimens in every group) on the basis of the core build-up materials used as group I: bulk-fill composites, group II: nanohybrid ormocer-based resins, and group III: nanofilled resin composites. Direct composite was used for core build-up and subjected to light-curing. Following this, the specimens were immersed in 1% methylene blue solution for 24 hours interval. Each section was evaluated for dye diffusion employing a stereomicroscope with software at a magnifying power of 40× and surface contact between dentin and base of the material was evaluated under scanning electron microscope. Results: Nanohybrid ormocer-based composites exhibited the least microleakage at 1.12 ± 0.14, in pursuit by nanofilled composite resins at 1.79 ± 0.09, and finally the bulk-fill composites at 2.85 ± 0.11, amid the investigational groups studied. A statistically significant difference amid the three dissimilar cores buildup substances was found upon analysis of variance. Conclusion: Despite the study limitations, this research came to a conclusion that each of the three investigated core build-up substances exhibited microleakage. However, amid the three, nanohybrid ormocer-based composites depicted the lowest amount of microleakage in pursuit by the nanofilled resins and the bulk-fill composites. Clinical significance: Core build-up is an important requirement as the remaining tooth substance following root canal treatment reduces and needs reinforcement with core build-up to sustain the tooth structure and provide resistance. A vital mandate for enduring efficiency of the restoration in the mouth is high-quality adhesive bond of these agents to cavity walls with diminished microleakage.


Akriti Batra, Vabitha Shetty

Effect of Twin-block Appliance on Pharyngeal Airway, Sleep Patterns, and Lung Volume in Children with Class II Malocclusion

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:8] [Pages No:66 - 73]

Keywords: Class II malocclusion, Lung volume, Pharyngeal airway, Sleep-disordered breathing, Twin block

   DOI: 10.5005/jp-journals-10024-3289  |  Open Access |  How to cite  | 


Aim: In this study, we sought to evaluate the effect of the twin-block appliance on pharyngeal airway dimensions, sleep patterns, and lung volumes in growing children with class II malocclusion with a retrognathic mandible. Materials and methods: Twenty children aged 9–12 years with class II malocclusion with a retrognathic mandible participated in the study. A validated sleep questionnaire assessed the sleep patterns and the sleep problems of the children. The pre-treatment cephalometric variables and the pharyngeal airway passage (PAP) dimensions were analyzed. Spirometry tests were performed to evaluate lung volumes. A custom-made twin-block appliance was fabricated, and children were instructed to wear it for a minimum of 10 months. All variables including sleep problems, cephalometric variables, and pharyngeal airway measurements were evaluated post-treatment. Spirometry tests were re-evaluated at the end of the twin-block treatment. All data were statistically analyzed. Results: Post-twin-block appliance treatment, there was a definite decrease in snoring, noisy breathing, and sleeping with mouth open. The sella-nasion to B point angle (SNB), mandibular length, the depths of oropharynx, nasopharynx, and hypopharynx as well as the height of nasopharynx (HNP) were significantly increased post-treatment (p <0.001). The length and thickness of soft palate (SPI) increased significantly (p <0.001), while its inclination decreased significantly (p <0.001). We found improvements in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1); however, the changes were statistically not significant (p = 0.88 and p = 0.78). Conclusion: Twin-block appliance significantly increased the pharyngeal airway dimensions and improved the length and thickness of the soft palate in children with class II malocclusion. Post-twin-block treatment showed a considerable reduction in the sleep problems of the children. The lung volume measurements showed improvement; however, it was not statistically significant. Clinical significance: Twin block may be used not only to correct the facial disharmony of children with a retrognathic mandible but also to improve the airway dimensions and lung volume as well as to reduce the sleep-disordered symptoms.


Juhi Deopujari, Henna Singh, Ipsita Pathak, Ritwik Shyamal, Shincy Mary Antony, Shreya Singh

Evaluation of Microcracks formed During Root Canal Preparation by Different File Systems Using Micro-computed Tomography: An In Vitro Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:74 - 78]

Keywords: Endomotor, Microcracks, Micro-computed tomography, NiTi Files, OneShape Rotary

   DOI: 10.5005/jp-journals-10024-3238  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to evaluate and compare the incidence of dentinal microcracks after instrumentation with various types of nickel-titanium (NiTi) files in rotary and reciprocating motion. Materials and methods: Fifty human extracted mandibular molars were taken and divided into five groups (n = ten teeth per group). Group I included ProTaper Gold, group II included OneShape, group III included WaveOne Gold, group IV included Reciproc, and group V included hand K files. The teeth were desectioned at the cemento-enamel junction (CEJ) and dentinal microcracks were observed under Micro-computed tomography. Postoperative Micro-computed tomography analysis of the samples was conducted to inspect cracks in the images obtained before and after preparation. Result: Results confirmed that there was a statistically significant difference between the study groups (p <0.05). The highest percentage of microcracks was seen in ProTaper Gold followed by OneShape. WaveOne Gold and Reciproc showed closely similar percentage of microcracks followed by hand K files that showed the least. Conclusion: Both rotary file systems showed higher number of microcracks than reciprocating file systems. Hand K files showed least microcracks formation among all studied groups. Clinical significance: Among all the tested methods and systems, hand K files demonstrated least incidence of dentinal microcracks. However, these hand K files systems are not advanced and have certain practical limitations. Reciprocating systems usually exhibits clinically acceptable microcracks therefore they may be judiciously utilized. Rotary file systems showed excellent biomechanical outcomes with redundant microcrack formation. Hence, precise selection of a particular system must be solely dependent upon the clinical decision making and circumstantial requirements.


Aparna Trivedi, Shivangi Trivedi, Harshita Narang, Piyali Sarkar, Bhumika Sehdev, Gowri Pendyala, Parwan Gill

Evaluation of Pre- and Post-loading Peri-implant Crestal Bone Levels Using Cone-beam Computed Tomography: An In Vivo Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:4] [Pages No:79 - 82]

Keywords: Cone-beam computed tomography, Crestal bone, Dental implant, Marginal bone loss

   DOI: 10.5005/jp-journals-10024-3245  |  Open Access |  How to cite  | 


Aim: To evaluate the buccal, lingual, mesial, and distal crestal bone around implant using CBCT analysis having buccal crestal bone width of 1 mm after placement of implant and after 3 months of loading. Materials and methods: Twenty-five patients between 18 and 60 years of age with adequate bone width and height were selected for this in-vivo study with single or multiple missing teeth. Surgical stent was fabricated for all of them by using self-cure acrylic resin for selection of implant according to the availability of bone, and gutta-percha was used as radio-opaque marker to locate the implant site. After proper analysis, in the first stage surgery, implants were placed. After 3 months to this, the second stage surgery was performed followed by elastomeric impression for porcelain fused to metal prosthesis fabrication. The buccal, lingual, mesial, and distal bone width and height were evaluated by using cone-beam computed tomography (CBCT). CBCT was standardized in terms of FOV (field of vision), slice thickness, and interval. After 3 months of loading, CBCT was taken to evaluate the alteration in the crestal bone around implants. Pre- and post-loading, crestal bone on four locations was measured by using CBCT software. Results: There is significant bone loss at all the locations, buccal, lingual, mesial, and distal, at the time of placement and after 3 months of loading of implant (p <0.05). The mean difference of 0.840, 0.933, 0.840, and 0.380 at buccal, lingual, mesial, and distal locations, respectively, shows statistically significant difference in pre- and post-values of mean bone loss at buccal, lingual, mesial, and distal positions. Pre-loading bone loss was maximum in the distal surface, while post-loading bone loss was maximum in the buccal surface. Conclusion: From this study, it is concluded that although crestal bone loss was higher before implant placement, there was significant alteration in crestal bone even after loading of implant. Clinical significance: It is widely accepted that the bone loss around the implant crest module is multidisciplinary in nature. Long-term preservation of the crestal bone is a paramount for successfully functioning of dental implants. Preserving crestal bone will help in dissipating the functional load. With proper treatment planning by the practitioner, this technical contribution to the crestal bone loss can be minimized and long-term survival of dental implants can be achieved.


Sumaiya Nezam, Puja Singh, Rashmi Ojha, Shabab Ahmed Khan, Neha Kumari, Neelu Kumari

Evaluation of the Antimicrobial Activity of Magnetized Water and Its Comparison with Chlorhexidine 0.2% in Young Children for 3 Weeks

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:83 - 88]

Keywords: Children, Chlorhexidine, Magnetized water

   DOI: 10.5005/jp-journals-10024-3237  |  Open Access |  How to cite  | 


Aim: The goal of this study was to compare the effects of magnetized water and 0.2% chlorhexidine mouthwash on gingivitis and plaque prevention in children aged 12–15 years for a period of 21 days. Materials and methods: A total of 24 youngsters between the ages of 12 and 15 years were chosen. A computer-generated random number sequence was used to split the research participants into two groups. Magnetized water was utilized as a mouthrinse in Category 1, while 0.2% chlorhexidine was employed in Category 2. Water purified with reverse osmosis was stored in glass bottles, which were then put near the magnets to create magnetic water. The magnets had 1000 Gauss power. The bottles were put for a period of 24 hours. The youngsters were given 140 mL of mouthrinse. These mouthrinses were to be used at home, they were told. The Gilmore Turesky adaptation of Quigley Hein\'s plaque index was used to assess the plaque whereas the gingival index recommended by Loe and Sillness was utilized to assess the gingiva. The plaque index and gingival index were analyzed at baseline, 14 days, and 21 days, as well as history and examination for adverse effects such as bitter taste, brownish discoloration, and so on, were recorded. The trial lasted 21 days with a follow-up period of another 21 days. Results: Both magnetic water and chlorhexidine were similarly successful in managing periodontal and gingival infections; however, magnetized water had less side effects, such as a bitter metallic taste and brown stains. Conclusion: Because of its well-accepted flavor, softer nature, and lower frequency of brown stains, magnetized water can be a safer and more acceptable alternative to chlorhexidine mouthwashes, especially in youngsters. Clinical significance: The use of chlorhexidine as a mouthrinse in the oral cavity has been linked to side effects. These side effects are mostly localized, such as brownish discoloration of teeth, alterations in taste perception, and erosion of the oral mucosa. As chlorhexidine has such negative side effects, it was necessary to do research, particularly in children, to identify a replacement that is similarly efficient against germs but does not have these side effects. Water treated with a magnetic field (magnetized water) was compared with chlorhexidine in the current study.


Jinal Desai, Indu M Varkey, Dharti Lad, Kiran D Ghule, Robin Mathew, Sheiba Gomes

Knowledge and Attitude about Infant Oral Health: A Paradox among Pregnant Women

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:6] [Pages No:89 - 94]

Keywords: Infant, Oral health awareness, Oral health education, Pregnancy

   DOI: 10.5005/jp-journals-10024-3266  |  Open Access |  How to cite  | 


Aim: To assess the knowledge and attitude of pregnant women about infant oral healthcare. Study design: A cross-sectional questionnaire study. Method: A cross-sectional survey was conducted among 350 primigravida women aged between 20 and 40 years visiting the DY Patil Medical Hospital for their antenatal examination. A multiple-choice questionnaire with 12 questions in addition to demographic information and socioeconomic status was designed in three languages. Results: Based on the level of education of the pregnant women, there was a statistically significant difference in knowledge and attitude toward infant oral healthcare (p = 0.001). The occupational status resounded significant differences between employed vs housewives and unemployed women (p = 0.000). Socioeconomic status also showed significant differences between the upper strata and lower strata groups (p = 0.000). Statistics: Data normality was tested using the Kolmogorov-Smirnov test and Shapiro-Wilk test. Since the data were not normally distributed, we used nonparametric tests for analysis. The total scores for different domains were compared between the different subgroups based on age, occupation, education, trimester, and socioeconomic status using nonparametric one-way ANOVA (Kruskal-Wallis test). Post-hoc pairwise comparisons were done using Bonferroni\'s method. All testing was done using two-sided tests with alpha = 0.05 (95% confidence level). Conclusion: This study gives us an insight into the inadequacies existing in our society amongst expectant women in relation to oral health-promoting factors for infants. Clinical significance: Educating pregnant women about maintaining their own oral health and care for their offspring will potentially help to curb early childhood dental diseases in future generations.


Ranjani Thillaigovindan, MA Eswaran, R Kesavan, Heba Ashi, A Thirumal Raj, Shankargouda Patil

Awareness and Attitude toward the Replacement of Missing Teeth among Patients at a Dental Institute: A Cross-sectional Study

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:95 - 99]

Keywords: Awareness, Edentulousness, Missing teeth, Stomatognathic

   DOI: 10.5005/jp-journals-10024-3293  |  Open Access |  How to cite  | 


Aim: To evaluate the awareness among the patients visiting a dental college in replacing the missing teeth. Materials and methods: A cross-sectional survey was conducted to know the patient\'s awareness and preference for the treatment options. A list of the closed-ended questionnaire was used to record the patient\'s response about being edentulous. The collected data were statistically analyzed. SPSS, Version 2.1, statistical software was used. The descriptive statistics were done using frequency and percentage. Bar graphs and pie graphs were used wherever applicable. Results: Maximum patients reported to dental treatment with less than 1 year period of edentulousness. This directly indicates an increased awareness among the patients (77.5%). The need to replace the missing teeth was a function such as mastication of food for 42.6% of the patients and 36.6% of the patients wanted to replace their missing teeth for improving their appearance. The most preferred method of the replacement is fixed partial denture (FPD) as it was cost-effective and affordable for them. Only 22% of the patients wanted an implant as a treatment option as it did not involve the adjacent teeth. Conclusion: The awareness and knowledge about the treatment options among the patients visiting the dental college have increased, but still, the awareness about the consequences of being edentulous for a long time should be improved through social media by the dentists. Clinical significance: The replacement of missing teeth is important in rehabilitating the form, function, esthetics, and integrity of the stomatognathic system. There are various treatment options available for replacing missing teeth. Very few patients are aware of all the options and the consequences of not replacing the posterior teeth.


Sathish Rajendran, Sruthi Srinivasan, Jaideep Mahendra, Little Mahendra, Harisha Dewan, Zeeshan H Ahmed, Hosam A Baeshen, Saranya Varadarajan, Shilpa Bhandi, Shankargouda Patil

Root Membrane Concept: Shield the Socket—A Case Report

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:100 - 104]

Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield

   DOI: 10.5005/jp-journals-10024-3261  |  Open Access |  How to cite  | 


Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique.


Anupama Aradya, Raghavendra Swamy Koodalakuppe Nagarajagowda, Ravi Maraballi Basavaraju, Sowmya Srinivas, Sindhu Sudhakar Kumararama

Influence of T-scan System on Occlusion Correction of Implant Supported Prostheses: A Systematic Review

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:13] [Pages No:105 - 117]

Keywords: Dental implants, Occlusion, Restorations, T-scan

   DOI: 10.5005/jp-journals-10024-3288  |  Open Access |  How to cite  | 


Aim: To systematically evaluate the literature evidence regarding the suitability of the T-scan occlusal system for implant supported prostheses. Materials and methods: A thorough bibliographic search was conducted on PubMed, Google Scholar, Cochrane library, Web of Science, EMBASE, and Scopus to collect relevant articles published from January 1, 2008 to August 30, 2021, using a combination of the following words: “T-scan,” “Implant supported prostheses,” and “dental implant” according to the PRISMA guidelines for the focused research question constructed using the PICO criteria. Randomized control trials, prospective studies, retrospective studies on the use of T-scan system in implant-supported prostheses reported in English language were included in the study. Results: This review consisted of 17 studies and 359 patients rehabilitated with 1,126 implants. In 3 studies, removable types of prostheses were given over implants, and in 14 studies, fixed types of prostheses were given. Nine studies determined the percentage of occlusal force magnitude and occlusion time sequence. Three studies measured the localization of the occlusion center. T-scan was used in two studies to measure the amount of gingival crevicular fluid after occlusal adjustment. The follow-up period ranged from 6 months to 2 years or more. Conclusion: T-scan proved with better results than other occlusal analysis indicators in terms of occlusion measurement, clinical execution, quantify the location and contact timing, and occlusion in 3D with more precision. Clinical significance: T-scan occlusal analysis system is widely used in dentistry and there is an increase in the number of studies, so a systematic review evaluating and comparing results is warranted.


Jayant Prakash, Kumar Ranvijay, Mahesh Shenoy, Zeeshan Qamar, Ahmed Mabkhot Ahmed Balabed, Khalid Mohammed Alkadi, Prashant Gupta

Clinical Success of Screw-retained Dental Implants: A Systematic Review

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:5] [Pages No:118 - 122]

Keywords: Fixed partial dentures, Implant-supported dentures, Marginal bone loss, Screw-retained implants

   DOI: 10.5005/jp-journals-10024-3231  |  Open Access |  How to cite  | 


Objective: The objective of the research was to review the literature on clinical evaluation and success of screw-retained dental implants by assessing the marginal bone loss (MBL). Methods: Online electronic databases such as PubMed/MEDLINE, Google Scholar, and Cochrane Library were searched using appropriate keywords for the last 20 years, dated from January 1, 2000, till August 1, 2021, with a restriction on language. Additional sources like major journals, unpublished studies, conference proceedings, and cross-references were explored. Information curated for data extraction included methodology, population, type of implants used, and duration of follow-up. Results: The PubMed/MEDLINE, Google Scholar, Cochrane Library, and additional sources identified a huge number, out of which 637 search results were screened, out of which 322 were duplicates. The remaining 315 unique studies were screened for the titles and abstracts, and 23 articles were selected for full-text screening. A total of six articles that matched the eligibility criteria were processed for qualitative analysis. Conclusion: Despite the uncertain retrievability of screw-retained implant-supported fixed restorations, this treatment option in fixed implant prosthodontics is a reliable and effective choice, especially for implant-supported long-span fixed partial dentures (FPDs), full-arch FPDs, and cantilever FPDs.


SV Sowmya, Dominic Augustine, Vanishri C Haragannavar, Elham A Khudhayr, Marwah H Matari, Wahba A Elagi, Neethi Gujjar, Shankargouda Patil

Cytogenetics in Oral Cancer: A Comprehensive Update

[Year:2022] [Month:January] [Volume:23] [Number:1] [Pages:9] [Pages No:123 - 131]

Keywords: Conventional cytogenetics, Fluorescent in situ hybridization, Microarray techniques, Molecular cytogenetics, Next-generation sequencing, Oral cancer

   DOI: 10.5005/jp-journals-10024-3223  |  Open Access |  How to cite  | 


Aim: To evaluate the application of cytogenetic techniques in determining the diagnosis, prognosis, and therapeutics in oral cancer. Background: Genetic aberrations that play an important role in oral oncogenesis demand substantial research for in-depth characterization of the tumor. Cytogenetic techniques have the potential to detect these aberrations. This review highlights about various cytogenetic approaches in cancer and how these findings support its application in the field of oral oncology. Methods: Google scholar search was done for articles on cancer cytogenetics, and in particular, PubMed database was queried for articles published from 2015 to 2020 using keywords cytogenetics, chromosomal aberrations, conventional cytogenetics, karyotyping, banding techniques, molecular cytogenetics, fluorescent in situ hybridization, spectral karyotyping, comparative genomic hybridization, multiplex ligation probe analysis, and next-generation sequencing (NGS) in oral cancer. Abstracts were reviewed, and relevant full text was accessed to extract the cytogenetic findings in oral cancer. Results: Data regarding various cytogenetic approaches from conventional to molecular techniques have been published in oral cancer. They convey a highly complex cytogenetic finding from gross chromosomal aberrations to specific gene mutations in oral cancer. Conclusion: Crucial information in the development and progression of oral cancer is achieved through cytogenetic findings in particular with the molecular cytogenetic techniques. Novel technologies like NGS have emerged in recent years that hold promise in the detection of these alterations more efficiently. Clinical significance: An appraisal of cytogenetic analysis in oral cancer helps to determine the diagnosis and the most important prognosticators. It assists in building targeted therapies for patient benefit.

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